[Objective]To compare spontaneous correction of the unfused thoracic curves after selective anterior versus posterior fusion in Lenke5 adolescent idiopathic scoliosis(AIS). [Method]A total of 72 Lenke5 AIS patients were rescruited from May 1997 to October 2005.Out of them,40 received selective anterior fusion(group A) and 32 received selective posterior fusion(group B).All had a minimum of 2-year follow-up.[Result] No complication were found in both groups at the latest follow-up.The thoracic curve was corrected from 30? to 16? for group A,33? to 18? for group B.Both groups had a better spontaneous correction of the unfused thoracic curves.The correction rate had no significant difference between groups.However,the thoracic curve was increased in four patients(2 in each group;group C),which resulted in trunk imbalance.The thoracolumbar/lumbar thoracic(TL/L:T) Cobb's ratio averaged 1.09 in the four patients whereas 1.59 in other 68 patients(group D).The flexibility of the thoracic curve had significant difference in group C and D(34.2% vs 57.3%).[Conclusion]Both of the surgical treatments can get a better spontaneous correction of the unfused thoracic curves.It is important to evaluate the.thoracolumbar/lumbar–thoracic(TL/L:T) Cobb's ratio and the flexibility of the thoracic curve before selective fusion.

Objective To investigate whether the combination of hydroxyapatite/tri-calcium phosphase (HA/TCP) and distraction osteogenesis technique would greatly reduce the time for the treatment of bone defects and enhance bone consolidation.Methods Osteotomy was made in the left tibia of all the 36 rabbits (age 20-24 weeks,body weight 2.2-2.8 kg),and a 1.0 cm length of the tibial shaft was removed below the tibiofibular junction.All rabbits were randomly divided into 3 groups,12 per group.Group A:The 1.0 cm defect gap was immediately reduced with the tibia shortened for 1.0 cm.Group B:The 1.0 cm defect gap was immediately filled with 1.0 cm restorable porous HA/TCP cylindrical block.Group C:The 1.0 cm defect gap was immediately reduced with the tibia shortened for 0.5 cm,and the remaining 0.5 cm defect gap was filled with 0.5 cm restorable porous HA/TCP cylindrical block.Then all the tibia was fixed with unilateral lengthener.For Group A and Group C,the lengthening started on the seventh day postoperatively,and lasted for 10 days and 5 days respectively.Group B didn't perform lengthening.All the rabbits wore terminated on the 37th days postoperatively.Serial radiographs were taken on the day of surgery,12,17,27 and 37 d postoperatively.The excised bone specimens were subject to micro-CT,mechanical testing,and histological examinations.Results Compared with the other two groups,the results in Group C were better in the terms of bone mineral content 454.44 ±89.98 mg,tissue mineral content 454.40±89.97 mg,maximum torque,maturity of regenerate bone,and the speed of bone consolidation and remodeling.Complete bone healing was achieved in the Group C within 37 days,but not in the Group A and B within 37 days.Conclusion The combination of HA/TCP and distraction osteogenesis technique can reduce the treatment time and promote bone consolidation compared with single treatment.

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· AIM: To summarize the clinical features of Chinese primary congenital glaucoma and to investigate the discrepancies of the clinical features between the Chinese and Indian patients.congenital glaucoma patients were reviewed. The clinical features were summarized as several quantifiable clinical parameters and the severity of the disease was evaluated. Both the quantified clinical features and severity were statistically compared with those of the Indian patients, which were cited from the previous published articles.included in the study. In Chinese patients, sex ratio (male to female )was about 2:1, family history was presented in 3 patients (7.5%) and consanguinity was found in one patient (2.5%). The main symptoms and signs observed in Chinese patients spanned a wide spectrum of manifestations. The most frequent signs noted on the initial examination were enlarged eyeball (42.5%) and decreased visual acuity (35.0%). Compared with Indian patients, Chinese patients had a later onset, a delayed diagnosis, more severe corneal changes and more severe optic nerve damages (P＜0.01). The combined tabeculectomy and trabeculotomy operation was preferred by both Chinese and Indian doctors whereas a higher proportion of Indian patients received the combined operation (P＜0.01). The proportions of the severity grade were different between Chinese and Indian patients. Most Chinese patients were in the severe grade while most Indian patients were in the very severe grade (P＜0.01).patients were sporadic and non-consanguineous.Compared with Indian patients, Chinese patients had a relative later onset, a delayed diagnosis and treatment.More attempts are needed in Chinese PCG prevention and treatment.

Purpose To investigate the expressions of PKCζ, MMP-2, and MMP-9 in breast cancer and the relationship with the inva-sion and metastasis of breast cancer. Methods The expression of PKCζ, MMP-2 and MMP-9 in 100 cases with breast cancer was as-sessed with immunohistochemistry PV 9000 method. PKCζ-siRNA was transfected into MDA-MB-231 cell lines, called siPKCζ/MDA-MB-231. While siRNA construct containing a scrambled sequence was transfected into MDA-MB-231 cells to generate control cells, which were designated as Scr/MDA231 cells. Western blotting was used to measure the expression of PKCζ in transfected cells, and the Transwell invasion assay was used to detect the invasion ability in vitro. The content of MMP-2, MMP-9 were measured by ELISA. Results The expression rates of PKCζ, MMP-2 and MMP-9 in breast cancer tissues were 62.5%, 37.5% and 32.5%, and there were significant differences among them (P<0.05). The expression of PKCζwas much higher than those in the normal breast tissues nearby. The expression of PKC protein was assoiated with lymph node metastasis, distant metastasis (P<0.01), but was not correla-ted with other clinicopathologic parameters, such as age, tumor size, histological type, ER, PR, and so on (P>0.05). The expres-sion of PKCζ, MMP-2 and MMP-9 were lower in siPKCζ/ MDA-MB-231 group than those in scr/ MDA-MB-231 group, and the in vitro invasion ability was significantly decreased (P<0.05). Conclusions PKCζ can promote the invasion and metastasis of breast canc-er, and correlated with the expression of MMP-2, MMP-9(P<0.05).

Objective:To study the relationship between dynamic Hoffmann's sign(DHS) and the early diagnosis of cervical spondylotic myelopathy. Methods:Patients with neck, shoulder and back pain (218 cases) were employed in this investigation. Among them, 96 cases had positive reaction to DHS test and they received 3 7 years follow up as study group. The other 122 cases negative to DHS test were taken as control group. The clinical data included the patient's symptoms and signs, sagittal diameter of cervical spinal canal, Pavlov rate, angular displacement and horizontal displacement between cervical vertebral, etc . Results:There were 72 cases in study group developed cervical spondylotic myelopathy and needed operation during follow up. Meanwhile, 11 cases in control group received surgical treatment. The incidence of stenosis of cervical spinal canal, herniation of cervical intervertebral disc and instability of cervical spine in DHS group were significantly higher than that of the control group. Conclusion:DHS is closely related to the onset of cervical spondylotic myelopathy. The patients should be followed up closely if they present positive reaction to DHS, and should be operated on early when their neurological symptom is progressing.

Objective: To evaluate the efficacy of the third-generation instrumentation including TSRH, CD and ISOLA in the treatment of adult scoliosis. Methods:Thirty-five adult patients with idiopathic or degenerative scoliosis who received treatment with third-generation instrumentation (TSRH,CD and ISOLA) between July 1999 to January 2003 were retrospectively reviewed. The mean preoperative cobb angle of major curves of the frontal plane was 58.1°(42°-95°). The patients received a combined anteroposterior approach or a single posterior procedure. The mean follow-up time was 20 months(10-48 months). Preoperative and postoperative Cobb angles of the frontal plane and sagittal plane and the distance between C7 and CVLS were measured. The subjective assessment was judged by questionnaire. Results: Postoperative clinical appearance of all patients improved significantly. Mean correction of major curves of the coronal plane was 53.2%. Mean loss of correction of the coronal plane in the last follow-up was 4.3°. The distance between the midline of C7 and CVSL was corrected from 2.6 cm to 0.24 cm. The results of follow-up showed that 89.3% patients were satisfied with the outcome. Pneumatothorax and haematothorax occurred in 2 patients. Three patients still complained of low back pain one year after operation because of adjacent degeneration in 2 patients and pseudoarthrosis in the remaining 1 patient. Conclusion: Imageologic findings and subjective assessment of the patients showed that the third-generation instrumentation can achieve good correction and trunk balance in the treatment of adult scoliosis with fewer complications.

Objective To study the clinical application of finger reconstruction by transplantation of two second toes and evaluate the postoperative appearance and function regarding the reconstructed hand and donor feet. Methods Defect of fingers were treated by transplantation and reconstruction with a total of 74 cases,including two second toes transplantation for both thumbs in 2 cases,thumb with index finger in 10 cas es, index finger with middle finger in 8 cases and middle finger with ring finger in 17 cases. Results Sevetythree fingers survived except 1 failed. During the follow up examination made from 3 to 36 months, the reconstructed fingers could move, write and dress with ease, pinch forcefully, show good recovery of manual work and the sensation of pain and warmth. Two-point discrimination found to be between 5 to 10 mm. Both donor feet have symmetrical appearance with normal gait and satisfactory motion. Also, no pain was complained.Conclusion Transplantation of two second toes from both feet is a good method to reconstruct defect of multiple fingers, and has little effect on the appearance and motion of feet.

Adult ; Female ; Hemangioblastoma ; pathology ; Humans ; Sella Turcica ; pathology ; Skull Neoplasms ; pathology

Objective:To compare the difference of LLD (leg length discrepancy) between robot-assisted and conventional methods of total hip arthroplasty (THA).Methods:Data of 38 patients who had THA performed by robot-assisted or conventional methods from January 2019 to May 2020 were retrospectively analyzed. There were 38 cases (54 hips) in robot-assisted THA group (robot group) with 18 males and 20 females (age 53.5±13.6 years, BMI 26.2±3.4 kg/m 2), and there were 21 cases (32 hips) with osteonecrosis of the femoral head, 17 cases (22 hips) with Crown typeⅠandⅡdevelopmental dysplasia of the hip. There were 38 cases (54 hips) in conventional THA group (conventional group), with 19 males and 19 females, (age 52.3±14.7 years old, BMI 25.7±2.9 kg/m 2), and there were 19 cases (30 hips) with developmental dysplasia of the hip, and 19 cases (24 hips) with osteonecrosis of the femoral head. The operative time, postoperative LLD, Harris score, forgotten joint score-12 (FJS-12) and the difference between preoperative and postoperative LLD between the two groups were compared, and the correlation between surgical methods and the change of hip length was also evaluated. Results:The operation time of the robot group was 73.3±14.1 min and which was 59.3±12.6 min in conventional THA group ( t=2.732, P=0.003). In the robot group, the postoperative LLD was 2.3±3.4 mm, which was less than that of the conventional group 6.7±5.4 mm ( t=3.521, P < 0.001). When the absolute value of LLD was larger than 5 mm as an abnormal value, it was 2.6% (1/38) in the robot group and 47.3% (18/38) in the conventional group. The difference of hip length (HL) in planning and post-operation in the robot group was 2.8±2.2 mm, which was smaller than that in the conventional THA group 7.9±5.3 mm ( t=2.357, P < 0.001). In addition, there was a correlation between the change of hip length results and the postoperative measurement of hip length in the robot group ( r=0.983, P < 0.001). At the last follow-up, Harris score and FJS-12 were recorded in the robot group and coventional group. The scores were 83.1±5.3 and 32.5±4.9 respectively in the robot group, 82.9±7.2 and 31.9±6.7 in the conventional group, respectively. There was no significant difference between the two groups ( t=0.221, 0.356; P=0.819, 0.731). Postoperative bleeding occurred in 1 case in the robot group with postoperative suture healed well. The fracture of the posterior wall of the acetabulum was found in the conventional group and the patient avoids weight bearing 4 weeks after operation. The postoperative recovery was good and no other related complications were found. Conclusion:Robot-assisted THA can accurately restore the length of both legs and reduce LLD compared with conventional THA. The real-time monitoring of LLD during robot operation can give the operator an accurate reference.